Healthcare Provider Details

I. General information

NPI: 1730158346
Provider Name (Legal Business Name): SARAH E BOTT P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ELIZABETH SPANGLER

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5335 DISCOVERY PARK BLVD STE B
WILLIAMSBURG VA
23188-2696
US

IV. Provider business mailing address

730 THIMBLE SHOALS BLVD STE 130
NEWPORT NEWS VA
23606-4562
US

V. Phone/Fax

Practice location:
  • Phone: 757-253-0603
  • Fax: 757-585-7645
Mailing address:
  • Phone: 757-873-1554
  • Fax: 757-873-3239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number110002183
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: